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Offline DCNGA  
#16 Posted : Tuesday, July 27, 2010 12:42:13 AM(UTC)
Rank: Advanced Member

Joined: 9/18/2008(UTC)
Posts: 7,198
Woman
Before venturing into the world of IPL (especially IPL) and lasers please do a great deal of research. You will be doing yourself a huge favor if you are well informed and educated in unpublished/unacknowledged side effects that doctors do not disclose on a consent form (but often admit to in the privacy of an exam room). Forewarned is forearmed!
Offline Larazelle  
#17 Posted : Tuesday, July 27, 2010 2:08:19 PM(UTC)
Rank: Advanced Member

Joined: 6/12/2008(UTC)
Posts: 2,365
kosmeds wrote:


Fraxel or Q-switched YAG. IPL might be helpful. I'm more of a peel fan, though--up to 8 moderate-depth TCA peels can be performed and they should be a lot cheaper than devices.

If the problem is deep in the dermis it might take years to resolve. If it's epidermal, 3-6 months of topical might be enough. I'd use a 4% hydroquinone (rx), keep using the retin-A, use PPD 30 STAT and lots of it, a wide-brimmed hat or visor, wrap-around sunglasses, and possibly higher strength glycolic acids on weekends. I'd also eliminate recreational sun exposure. If that's not possible, then reapply the sunscreen every hour and use only something with a PPD of at least 28 which eliminates almost everything except the most protective Bioderma and Anthelios European formulas.

Other things that might be mildly useful are azelaic acid, vitamin C, kojic acid, and niacinamide.

It will help if your derm is an expert in pigmentation problems in people with your skin type.



Hey Doctor -

You are so right about the length of time it takes for pigmentation that lies in the dermis to diminish - I had Fraxel in January 2007 - and only NOW - 2010 - it is not that noticeable - I know it is dermal as they checked it with the Woodslamp - what worked was Azelaic acid - the interesting thing about it is that it depigments the skin but only where it is hyperpigmented - so normal skin does not get lighter - though sometimes it does - I have no choice but to use it - since it seems to be working - the other day MissJ saw me at CVS and said it looked fine - (BTW Jane, if you are reading this - I e-mailed you about doing my hair- you were out probably out swimming around Walden Pond - LOL- so I did it myself and it came out fine) -
Offline MissJ  
#18 Posted : Tuesday, July 27, 2010 3:15:46 PM(UTC)
Rank: Administration

Joined: 5/14/2008(UTC)
Posts: 23,621
Larazelle,
Glad your hair came out fine. I've yet to do mine.
Offline Sophia  
#19 Posted : Tuesday, July 27, 2010 11:12:55 PM(UTC)
Rank: Advanced Member

Joined: 7/21/2008(UTC)
Posts: 404
Thanks kosmeds! Thanks so much!
Will follow your instructions. It sounds like a really good plan!


kosmeds wrote:


This study found glycolic 20-35% to be more effective than TCA 10=20%
http://www.ncbi.nlm.nih.gov/pubmed/20657143

Any other AHA will be less effective than glycolic (assuming same concentration and pH) and salicylic will not be as effective, either. Glycolic has the smallest molecule and penetrates most deeply.

It's probably not a good idea to try more than 20% TCA at home, especially unbuffered. You could scar yourself. I'd get the derm to do a series of real peels at 35% with a pre-peel. These will take about 2 weeks to recover from, each, they are very serious and painful. It might take 8 of them.

Adding an ascorbic acid topical will improve efficacy.
http://www.ncbi.nlm.nih.gov/pubmed/17524124

But use your HQ and tretinoin also. Three months on HQ, three months off HQ is probably the safest way to use it. Some people get worse when they use too much of it because it can make the melanocytes go crazy, but most of these people are probably not taking their sun protection very seriously.
Offline kacey06  
#20 Posted : Wednesday, July 28, 2010 7:49:02 AM(UTC)
Rank: Advanced Member

Joined: 6/5/2008(UTC)
Posts: 143
Larazelle wrote:



Hey Doctor -

You are so right about the length of time it takes for pigmentation that lies in the dermis to diminish - I had Fraxel in January 2007 - and only NOW - 2010 - it is not that noticeable - I know it is dermal as they checked it with the Woodslamp - what worked was Azelaic acid - the interesting thing about it is that it depigments the skin but only where it is hyperpigmented - so normal skin does not get lighter - though sometimes it does - I have no choice but to use it - since it seems to be working - the other day MissJ saw me at CVS and said it looked fine - (BTW Jane, if you are reading this - I e-mailed you about doing my hair- you were out probably out swimming around Walden Pond - LOL- so I did it myself and it came out fine) -


Larazelle, does the azelaic acid give you an even look to your skin? I have some redness in my cheeks and some age spots and I have been seriously thinking about the azelaic acid.
Offline Larazelle  
#21 Posted : Wednesday, July 28, 2010 8:15:54 AM(UTC)
Rank: Advanced Member

Joined: 6/12/2008(UTC)
Posts: 2,365
kacey06 wrote:


Larazelle, does the azelaic acid give you an even look to your skin? I have some redness in my cheeks and some age spots and I have been seriously thinking about the azelaic acid.



I don't know about redness - but it does take away hyperpigmentation - which age spots are a form of - so it may help - try mixing it with some Retin A - I'm going to do that in the winter -
Offline kacey06  
#22 Posted : Thursday, July 29, 2010 12:15:11 AM(UTC)
Rank: Advanced Member

Joined: 6/5/2008(UTC)
Posts: 143
Thanks, Larazelle. I just ordered a tube of Finacea, so we'll see if it helps my redness and brown spots. I am just guessing they are age spots, as they are slightly bigger than freckles and I only have a handful of them on my face.
Offline kacey06  
#23 Posted : Monday, August 23, 2010 12:01:48 AM(UTC)
Rank: Advanced Member

Joined: 6/5/2008(UTC)
Posts: 143
Larazelle wrote:



I don't know about redness - but it does take away hyperpigmentation - which age spots are a form of - so it may help - try mixing it with some Retin A - I'm going to do that in the winter -


Hi Larazelle. I have been using my finacea every other day and my Retin A on the alternate days. Do you mean to actually mix the Retin A with the Finacea and apply? Do you use the finacea daily?
Offline Larazelle  
#24 Posted : Monday, August 23, 2010 4:17:30 AM(UTC)
Rank: Advanced Member

Joined: 6/12/2008(UTC)
Posts: 2,365
kacey06 wrote:


Hi Larazelle. I have been using my finacea every other day and my Retin A on the alternate days. Do you mean to actually mix the Retin A with the Finacea and apply? Do you use the finacea daily?



Hi Kacey -

yes - I take equal portions of the two and mix them well and then apply - so far I have just been using Azelexc (without Retin A) but in the fall and winter I will start this combination -
Offline kacey06  
#25 Posted : Monday, August 23, 2010 11:44:05 PM(UTC)
Rank: Advanced Member

Joined: 6/5/2008(UTC)
Posts: 143
OK. Thanks, Larazelle. Just 1 more question. Hope you don't mind! Do you think the Finacea is best used daily instead of every other day like I am using it?
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